APPLICATION FORM
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APPLICATION FORM |
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| Name: Vasyl | Surname: Eramasov | ||||||
| Date of birth: 05.11.1960 | Place of birth: Ukraine | ||||||
| Permanent address: Sevastopol, Ukraine | |||||||
| Passport (OVIR): EA 476027 | Place of issue: Sevastopol | Date of issue: 04.12.2007 | Valid until: 04.12.2017 | ||||
| Seaman’s book: AB 310020 | Place of issue: Sevastopol | Date of issue: 05.06.2006 | Valid until: 05.06.2011 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | . | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Satisfactory | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Lomonosov Secondary Naval School | Tech. Navigator | AT 041566 | 20.12.1982 | ||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00277/2006/10 | Sevastopol |
09.06.2006 |
--- |
| Endorsement STCW | 00277/2006/10 | Kherson |
18.07.2007 |
03.10.2008 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 03860C | Sevastopol |
12.05.2006 |
13.05.2011 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00384/2003/09 | Sevastopol |
10.10.2003 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00384/2003/09 | Sevastopol |
16.10.2003 |
03.10.2008 |
| Radar Observation and Plotting (A-II/1,2) | 0169C | Sevastopol |
13.05.2006 |
14.05.2011 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 0169C | Sevastopol |
13.05.2006 |
14.05.2011 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 0430C | Sevastopol |
11.05.2006 |
12.05.2011 |
| Advanced Fire Fighting (A-VI/3) | 01596C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 00490C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Ship's Medical Care (A-VI/4-2) | 0532C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Ship handling arrangements | 00126/2006/44/60 | Sevastopol |
22.05.2006 |
22.05.2011 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | C33/2004 | Sevastopol |
15.06.2004 |
15.06.2009 |
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Tanker Certificates: |
. |
. |
. |
. |
| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 00115/2007/42/12 | Sevastopol |
11.07.2007 |
11.07.2012 |
| Tanker Familiarization | 00510C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0532C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Crude oil washing | 00057C | Sevastopol |
12.05.2006 |
13.05.2011 |
| Inert gas system | 0563/2006 | Sevastopol |
12.05.2006 |
13.05.2011 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Argoat | Seaport Int. Ship. Co |
3500 |
France |
Oil tanker |
Ch. Off |
14.04.2003 |
10.08.2003 |
| Vostochnyy | Sevmorrybport |
2200 |
Ukraine |
Oil tanker |
Ch. Off |
15.10.2003 |
15.10.2004 |
| Rising One | Rising Plastic Inc. |
3500 |
Panama |
Oil tanker |
Ch. Off |
20.03.2005 |
30.08.2005 |
| Uzhnyy | Sevmorrybport |
2200 |
Ukraine |
cargo/oil tanker |
Ch. Off |
23.09.2005 |
10.04.2006 |
| Uzhnyy | Sevmorrybport |
2200 |
Ukraine |
cargo/oil tanker |
Ch. Off |
10.10.2006 |
10.05.2007 |
| Ellen | Cowen |
2525 |
St.Kitts&Nevis |
Ch./oil tanker |
Ch. Off |
13.07.2007 |
25.09.2007 |
| Ellen | Cowen |
2525 |
St.Kitts&Nevis |
Ch./oil tanker |
Master |
25.09.2007 |
20.10.2007 |
| Experience at sea: Since 1982 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 1747 | Issued: 13.07.2007 | Place: Sevastopol | Exp. date: 13.07.2008 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 23.02.2000 | |||