APPLICATION FORM
|
|
APPLICATION FORM |
|
| Name: Valeriy | Surname: Yakovlyev | ||||||
| Date of birth: 31.10.1980 | Place of birth: Samara, Russia | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): PO 650454 | Place of issue: Odessa | Date of issue: 14.03.2007 | Valid until: 14.03.2017 | ||||
| Seaman’s book: AB 370104 | Place of issue: Odessa | Date of issue: 23.04.2008 | Valid until: 23.04.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Oksana Yakovlyeva | ||||||
| Supported children under age of 18 | 1. Mikita Yakovlyev, 05.05.2006 | ||||||
| (name, surname, date of birth) | 2. Katerina Yakovlyeva, 05.05.2006 | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Odessa National Maritime Academy | Engineer | 28.02.2003 | |||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01532/2007/08 | Odessa |
15.10.2007 |
--- |
| Endorsement STCW | 01532/2007/08 | Odessa |
15.10.2007 |
22.08.2012 |
| Personal Sea Survival techniques, fire prevention and fire fighting | 93713/2007 | Odessa |
22.08.2007 |
22.08.2012 |
| Advanced Fire Fighting (A-VI/3) | 47748/2007 | Odessa |
22.08.2007 |
22.08.2012 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats | 53636/2007 | Odessa |
22.08.2007 |
22.08.2012 |
| Medical First Aid (A-VI/4-1) | 35036/2007 | Odessa |
22.08.2007 |
22.08.2012 |
| Maintenance of Electrical and Electronic Engineering | 0640/2007 | Odessa |
31.08.2007 |
--- |
| Refresher and updating courses (II/1) | ÑÏÊ 481290 | Odessa |
10.09.2007 |
--- |
| Dutch Seaman's book | 00232920 | Hague |
02.04.2007 |
02.04.2017 |
| Dutch Endorsement | 8500167037/10007725 | Hague |
05.11.2007 |
22.08.2012 |
|
Tanker Certificates |
|
| ||
| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0940/2007 | Odessa |
14.09.2007 |
14.09.2012 |
| LPG carrier (Advanced and Familiarization, A-V/1, p.2-7) | 0962/2007 | Odessa |
14.09.2007 |
14.09.2012 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0950/2007 | Odessa |
14.09.2007 |
14.09.2012 |
| Crude oil washing | 0406/2007 | Odessa |
14.09.2007 |
14.09.2012 |
| Inert gas system | 0365/2007 | Odessa |
14.09.2007 |
14.09.2012 |
Sea service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Fairmount Sherpa | Interbroker | 3239 | Panama | AHTS |
3-rd Eng |
04.10.2006 |
27.01.2007 |
| 2. Coral Rubrun | Interbroker | 5469 | Dutch | LPG/E |
3-rd Eng |
31.03.2007 |
08.08.2007 |
| 3. Coral Isis | Interbroker | 6788 | Dutch | LPG |
3-rd Eng |
19.10.2007 |
23.02.2008 |
| 4. Coral Millepora | Interbroker | 4054 | Dutch | LPG |
2-nd Eng |
31.05.2008 |
31.10.2008 |
| 5. Coral Millepora | Interbroker | 4054 | Dutch | LPG |
2-nd Eng |
08.03.2009 |
12.07.2009 |
| 6. Monte Chiaro | ASP Shipmanagement | Italy | Ch. Tanker |
2-nd Eng |
02.11.2009 |
02.04.2010 |
|
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. |
Wartsila |
4 |
4x4023 |
Caterpillar/2 |
/600 |
no |
without |
| 2. A1 |
Man B&W |
2 |
5632 |
Man B&W/3 |
/900 |
yes |
without |
| 3. A2 |
Man B&W |
2 |
5284 |
Crepelle/3 |
/ |
yes |
without |
| 4. A2 |
Wartsila |
4 |
3970 |
Caterpillar/2 |
/600 |
yes |
without |
| 5. A2 |
Wartsila |
4 |
3970 |
Caterpillar/2 |
/600 |
yes |
without |
| 6. A2 |
Wartsila |
4 |
2x4023 |
Wartsila/2 |
/1060 |
yes |
with |
| Experience at sea: Since 2003 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ 019417 | Issued: 03.09.2009 | Place: Odessa | Exp.date: 03.09.2010 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 27.03.2010 | |||