APPLICATION FORM
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APPLICATION FORM |
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| Name: Andriy | Surname: Khryukin | |||
| Date of birth: 29.06.1964 | Place of birth: Moscow, Russia | |||
| Permanent address: Odessa, Ukraine | ||||
| Passport (OVIR): AC 717338 | Place of issue: Odessa | Date of issue: 03.10.2005 | Valid until: 03.10.2010 | |
| Seaman’s book: AB 335450 | Place of issue: Odessa | Date of issue: 04.02.1999 | Valid until: 04.02.2009 | |
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | |||
| Marital Status: | Married | |||
| Next of kin: (name, pas. No) | wife - Shabalina Svetlana | |||
| Supported children under age of 18 | 1. Shabalina Maria, 20.10.2005 | |||
| (name, surname, date of birth) | . | |||
| Knowledge of English language: | Good | |||
| Education: | Qualification: | No Diploma: | Date of Issue: | |
| Odessa Secondary Marine College | El. Engineer | . | 02.12.2004 | |
| Odessa Polytechnic University | El. Engineer | . | 24.06.1986 | |
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 02563/2004/01 | Izmail |
22.12.2004 |
--- |
| Endorsement STCW | 02563/2004/01 | Izmail |
22.12.2004 |
22.12.2009 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 76750/2004 | Odessa |
30.11.2004 |
30.11.2009 |
| Advanced Fire Fighting (A-VI/3) | 36662/2004 | Odessa |
30.11.2004 |
30.11.2009 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 40231/2004 | Odessa |
30.11.2004 |
30.11.2009 |
| Medical First Aid (A-VI/4-1) | 27045/2004 |
Odessa |
30.11.2004 |
30.11.2009 |
| Bermuda Seaman's book | 20963 | Bermuda |
23.10.2007 |
21.10.2017 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 2057/2004 | Odessa |
04.06.2004 |
04.07.2009 |
|
Tanker Certificates: |
. |
. |
. |
. |
| LPG carrier (Advanced and Familiarization, A-V/1, p.2-7) | 00129B |
Odessa |
10.07.2007 |
10.07.2012 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 01597B | Odessa |
10.07.2007 |
10.07.2012 |
| Crude oil washing | 00495B | Odessa |
10.07.2007 |
10.07.2012 |
| Inert gas system | 01684B | Odessa |
10.07.2007 |
10.07.2012 |
Sea service (during five last years):
|
N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | Yannis P | Centrofin |
159981 |
Greece |
Tanker |
El.Engineer |
11.06.2004 |
14.11.2004 |
| 2. | Pannagia Armata | Centrofin |
98774 |
Greece |
Tanker |
El.Engineer |
01.09.2005 |
22.11.2005 |
| 3. | Georgios S. | Centrofin |
159981 |
Greece |
Tanker |
El.Engineer |
22.11.2005 |
09.07.2006 |
| 4. | Ce-Venture | Centrofin |
96101 |
Liberia |
Tanker |
El.Engineer |
19.11.2006 |
17.06.2007 |
| 5. | Methane Lydon Volney | BG LNG Serv |
95753 |
Bermudas |
LNG |
El.Engineer |
25.10.2007 |
10.02.2008 |
| 6. | Methane Rita Andrea | BG LNG |
95753 |
Bermudas |
LNG |
El.Engineer |
04.06.2008 |
04.10.2008 |
|
N |
Main Eng. Maker/Model |
Engine Total HP |
Aux.Engine Maker/Number,s |
Aux. Engine H.P. / KW |
Voltage (220/380/440) |
Automation class (A1/A2) |
Automation System Maker |
Crane/Maker/ Type/SWL |
Derrick/Maker/ Type/SWL |
|
1. |
B&W |
22921 |
Yanmar8N2IL-GV |
3x1200 |
440 |
A1 |
Nor control |
. |
. |
|
2. |
B&W |
19100 |
Yanmar6T240LSX |
3x950 |
440 |
A1 |
Nor control |
. |
. |
|
3. |
B&W |
22921 |
Yanmar8N2IL-GV |
3x1200 |
440 |
A1 |
Nor control |
. |
. |
|
4. |
Sulzer |
13870 |
Yanmar6T240LSX |
3x950 |
440 |
A1 |
Nor control |
. |
. |
|
5. |
KawasakiUA-400 |
33550 |
Ishiashi Steam |
3x3450 |
660 |
A1 |
Kongsberg |
. |
. |
|
6. |
KawasakiUA-400 |
33550 |
Ishiashi Steam |
3x3450 |
660 |
A1 |
Kongsberg |
. |
. |
| Experience at sea: Since 1999 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: | Place: | Exp. date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 2011 | |||
Ready to work from: any time