APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleg | Surname: Arkhishin | ||||||
| Date of birth: 15.01.1968 | Place of birth: USSR | ||||||
| Permanent address: Togliatty, Russia | |||||||
| Passport (OVIR): 62 7386298 | Place of issue: Togliatty | Date of issue: 20.04.2006 | Valid until: 20.04.2011 | ||||
| Seaman’s book: RF 0069904 | Place of issue: Samara | Date of issue: 03.03.2006 | Valid until: 03.03.2011 | ||||
| Citizenship: Russia | Expiry date of U.S. visa: 19.04.2011 | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Julia Arkhishina | ||||||
| Supported children under age of 18 | 1. Anton Arkhishin | ||||||
| (name, surname, date of birth) | 2. Anastasia Arkhishina | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Riga Marine College | 3-rd Eng | 29.08.1987 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 2031301947 | Astrakhan |
28.07.2008 |
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| Endorsement STCW | 2031321902 | Astrakhan |
28.07.2008 |
17.06.2010 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 031582 | Samara |
01.07.2005 |
01.07.2010 |
| Advanced Fire Fighting (A-VI/3) | 005431 | Samara |
01.07.2005 |
01.07.2010 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 033506 | Samara |
01.07.2005 |
01.07.2010 |
| Medical First Aid (A-VI/4-1) | 008329 | Samara |
04.08.2005 |
04.08.2010 |
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Tanker Certificates |
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| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 029591 | Samara |
29.06.2005 |
29.06.2010 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 029507 | Samara |
17.06.2005 |
17.06.2010 |
Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Estella | Samlot | 10873 | Panama | Ch./Oil Tanker |
3-rd Eng |
11.2004 |
06.2005 |
| 2. Estella | Samlot | 10873 | Panama | Ch./Oil Tanker |
3-rd Eng |
10.2005 |
02.2006 |
| 3. Gaz Unity | Novikontas | 48422 | Panama | LPG |
3-rd Eng |
29.05.2006 |
20.10.2006 |
| 4. Teal | Anglo-Eastern Group | 22835 | N.Antilles | Heavy lift |
3-rd Eng |
13.03.2007 |
15.07.2007 |
| 5. Target | Anglo-Eastern Group | 42515 | N.Antilles | Heavy lift |
3-rd Eng |
19.12.2007 |
19.04.2008 |
| 6. Triumph | Anglo-Eastern Group | 42515 | N.Antilles | Heavy lift |
3-rd Eng |
21.10.2008 |
22.02.2009 |
| 7. Heleen-C | CarisBrooke Shipping | 13700 | UK | Gen. cargo |
2-nd Eng |
14.05.2009 |
06.09.2009 |
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Automation (A1/A2) |
Main Eng. Maker/Model |
Engine Stroke |
Engine Total HP |
Aux. Engine Maker/Number |
Aux. Engine H.P. / KW |
Unmanned |
Without El.Eng. |
| 1. |
MitsuiSA7CY45 |
2 |
4530 |
Daihatsu |
/400 |
No |
No |
| 2. |
MitsuiSA7CY45 |
2 |
4530 |
Daihatsu |
/400 |
No |
No |
| 3. |
Sulzer 6RLA90 |
2 |
21600 |
Daihatsu |
/800 |
No |
No |
| 4. A1 |
B&W |
2 |
13100 |
Man B&W |
/1250 |
No |
No |
| 5. A1 |
Man B&W |
2 |
13631 |
Man B&W |
/1250 |
No |
No |
| 6. A1 |
Man B&W |
2 |
13631 |
Man B&W |
/1250 |
No |
No |
| 7. A1 |
Man B&W |
2 |
5180 |
Daihatsu |
/440 |
Yes |
Yes |
| Experience at sea: Since 1989 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: 16.04.2009 | Place: Samara | Exp.date: 16.04.2010 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 11.07.2015 | |||