Старший механик( Специализированное управление № 4 )

Описание

APPLICATION FOR NEW EMPLOYMENT Position Applied for : Chief Engineer Available for Services from : 01.04.2023. Date : 01.04.2023. Place : Vladivostok Signature : Alexander Middle Pavlovich Surname Novikov Name first VLADIVOSTOK Home Port : (Please specify Homeport basis Crewing Center you are processed through) : 09.02.1958 Vladivostok / USSR Date & Place of Birth RUS 0516941 Date & Place of Issue 27.10.2020 / Vladivostok Valid till 26.10.2025. Seaman’s Pass. No 76 5067985 Date & Place of Issue 23.07.2021 / Vladivostok Valid till 23.07.2031. Int. Pass. No. 05 04 037914 Date & Place of Issue 01.04.2005 / Vladivostok Civil. Pass. No Vladivostok., 9 Flat, 33 Olega Koshevogo Street Tel : +79940171758 Permanent Address Nov1958@bk.ru Mobile E-MAIL ADDRESS: Vladivostok., 9 Flat, 33 Olega Koshevogo Street Tel : Present Address Marred Wife’s Name Shashkova Svetlana Anatolievna Marital Status Relationship Next of kin Tel : Address of Next of kin PREVIOUS SERVICE (for last 10 years) Name of Company/ Vessel Crewing 2. List the nationalities of Superintendents that you have worked with Russian, American, Greek, South Korean, German, Norwegian, Netherland. 3. The type of cargoes you have carried Cars, Wood, Coal, Ore, Rice, Ref.Food, Metal, etc. 4. Type/Model/BHP of Maine/Aux Engines All Trunkpiston Engines, BW,MAN Crosshead 2stroke Engines. 5. List the trading areas you have sailed Everywhere MARINE EDUCATION Name of School/University/ Academy Date of Graduation Profession and Form of Education DD/MМ/YYYY Vladivostok Secondaru Marine School 30.11.1977. Ships power plants operation Far Eastern State Technical Fishering University Vladivostok. 28.06.2005. Ships power plants operation Date and Company of beginning of sea service 28.02.1978. Far Eastern Life-Saving Shipping. Rescuers and tug boats. STCW LICENCES Chief Engineer No. 3015500067 National License Grade 20.07.2021 / Vladivostok 28.06.2026. Date & Place of Issue Valid till Liberia License Grade No Valid till Liberia C.D.C. No Valid till Panama License Grade No Valid till No Valid till Panama C.D.C. Other License Grade(specify) No Valid till Other C.D.C. No (specify) Valid till Other License Grade(specify) No Valid till Other C.D.C. No (specify) Valid till Other License Grade(specify) No Valid till Other C.D.C. No (specify) Valid till COURSES ATTENDED NUMBER DATE ISSUE VALID 1) PERSONAL SURV. COURSE(PST/FP & FF/EFAID/PSSR) 1683204 13.07.2021. 12.07.2026. 2) MEDICAL FIRST AID/ MEDICAL CARE 1643720 06.07.2021. 05.07.2026. 3) ADVANCED FIRE FIGHTING 1642605 01.07.2021. 30.07.2026. 4) P.S.C. & R.B. 1641696 30.06.2021. 29.06.2026. 5) TANKER SAFETY (OIL/COW) TANKER FAM (OIL) 6) TS CHEMICAL / TF CHEMICAL 7) TS GAS / TF GAS 8) DANGEROUS CARGO ENDORSEMENT (OIL/GAS/CHEMICAL) 9) A.R.P.A /RADAR OBSERVER 10) G.M.D.S.S. 11) B.T.M./B.R.M. 12) ISPS Code / SSO CBK. 1874.11 10.09.2021. 10.09.2026. 13) YELLOW FEVER 12.08.2014. 12.08.2024. 14) USA C1R TYPE VISA 15) OTHER (SPECIFY)__MARPOL 067866 02.09.2022. 02.09.2027. 16) OTHER (SPECIFY)__Medical certificate 50682830 06.09.2022. 06.09.2023. 17) OTHER (SPECIFY)__Basic safety training 1784189 29.06.2021. 28.06.2026. 18) OTHER (SPECIFY)__ 19) OTHER (SPECIFY)__ 20) OTHER (SPECIFY)__ REFERENCES FM PREVIOUS EMPLOYERS CAN BE CHECKED VIA: Vessel Crewing Agent or Tel No Name of person in charge Ship-Owner E-mail/Address 1 Thor CREWMEN. 2424926, 2420614, Vladivost. Bely Igor Viktorovich 2 Tabernakle Prince OSM 0773864877. Colombo S.Premakumaran 3 DD Victory DMZ Crewing Limited 4232612566 Fax. Vladivostok Zorin B.B. 4 PERSONAL DATA Color of hair Color of eyes Height (cm) Weight (kgs) Shoes size Overall size Dark Gray-green 166 85 41 54 I DECLARE THAT TO THE BEST OF MY KNOWLEDGE ALL PARTICULARS SUPPLIED BY ME ARE CORRECT AND COMPLETE. Date ______________________________________ Applicant signature ____________________________________________________ FOR OFFICIAL USE ONLY ( TO BE FILLED (ROUND;EXTRACT) BY INTERVIEWER)): English – poor; middle; good; fluent spoken Computer test result: Not passed yet Conduct - satisfactory; not satisfactory Reliability – reliable; self-motivated; not initiative; unreliable Knowledge of duties & responsibilities of the rank – exceptionally skilled; good skills; incompetent Special remarks: (type of engines; equipments; special and additional proof knowledge; mixed crews and others) ………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… Conclusion: Suitable for employment ; Not suitable for employment