Капитан на шаланду-камневоз
Описание
APPLICATION FORM
CATEGORY:
DATE OF READINESS wages DESIRE CONTR. PERIOD DESIRE nearest airport
3-4 month Khrabrovo,Kaliningrad
COMMENTS: DON'T FILL IN THIS COLUMN
Height: 168 sm Weight: 85 kg Overall: xl Shoes: 41 Color of eyes: brown Color of hair: gray
distinguishing marks (Scars, tattoos etc.)
Surname, Name, MIDDLE NAME Surkov Leonid Petrovich
DATE AND PLACE OF BERTH 29/04/1954, Voronezh, Russia
Nationality and Citizenship RUSSIAN
POST BOX, ADDRESS (REGISTRATION) BOX 236022, Str. Oficerskaya 16, apart 8, KALININGRAD, RUSSIA ,
POST BOX, ADDRESS (RESIDENCE) Oficerskaya Str.16 aprt 8 KALININGRAD, RUSSIA , BOX 236022
CONTACT DETAILS Home ( Mobile ( Contact ( E-mail / Skype / ICQ
+79118598639 lpsurkov@gmail.com
The marital status (mark X) SINGLE MARRIED X separated DIVORCED WIDOWER
THE NEXT OF KIN, NAME AND SURNAME Ludmila Surkova, wife
THE ADDRESS, TELEPHONE Oficerskaya Str.16 aprt 8 KALININGRAD, RUSSIA , 236022
CHILDREN (NAME, DATE OF BERTH)
WIFE'S NAME (MAIDEN NAME), DOB Ludmila Surkova, 27/05/1957
THE DATE OF VISA EXPIRE USA Schengen OTHERS:
REGISTERED NUMBER OF THE VISA
Educational institutions, the years KALININGRAD Marine College , 1986
OF GRADUATION AND DIPLOMA RECEIVED Navigator
FOREIGN LANGUAGES KNOWLEDGE ENGLISH GERMAN SPANISH OTHERS:
LEVELS: 0 – 1 – 2 – 3 – 4 – 5 4
MARLINS (OR ANY OTHER) TEST
SEA SERVICE FOR THE LAST 5 YEARS (OR LAST 7 CONTRACTS)
SHIP'S SHIP'S NAME AND YEAR OF BUILT FLAG GRT M/E TYPE kwt RANK SIGN ON SIGN OFF SHIPOWNER / EMPLOYER
TYPE CRANES, TEUs HFO/ MDO DD.MM.YY DD.MM.YY CREWING AGENCY
Container Mv Angela, 868 Gibralt9962 9M43 MAK 8400 Master 27/08/2008 26/08/2020 Myklebusthaug/NORDBEGR LTD
ar
HopperbargZORKIY RF 529 Volvo-Penta 2x300 Master 27/07/2022 24/10/2022 MPaT Ltd
e
Hopper Yasnyy RF 529 Volvo-Penta 2x300 Master 03/03/2023 10/07/2023 MGaT LT
barge
www.kofcrewing.com
WORKING EXPERIENCE AND REFERENCES:
Indicate trading areas where you had working experience : world wide
Did You work with mixed crew? If yes, what the nationalities? : YES, philipinnes, polish, german, llithuanian
REFERENCES CAN BE RECEIVED FROM:
NAME: RANK: Contact details:
List of the Documents Number Issuing Date and country Expire date
Seaman's Passport
Travel Passport 76 9359154 17.11.2022 17.11.2032
Passport (Any other)
Seafarer's identity document RUS 0499935 23.12.2020 23.11.2025
Seaman's book russian MK 0126712 08.08.2011 RUSSIA
Seaman’s book
Seaman’s book
Licence russian / grade: mASTER KGD 205628825 28.06.2022 28.05.2027
Licence / GRADE:
Licence / GRADE:
Oil TANKER endorsement
chemical TANKER endorsement
gas TANKER endorsement
Oil Tanker Familiarization TRAINING course
Chemical Tanker Familiarization TRAINING course
Gas Tanker Familiarization TRAINING course
Oil TANKER specialized training program
chemical TANKER specialized training program
gas TANKER specialized training program
Crude oil washing operations, inert gas system
GMDSS GENERAL operator KGD 205628741 28.06.2022 26.05.2027
GMDSS GENERAL operator Endorsement
ROP
ARPA 163224 21.06.2022 21.06.2027
1.01.0363/2022 13.05.2022 13.05.2027
Personal survival techniques, fire prevention AND Fire-fighting,
elementary first aid, personal safety and social Responsibility
Proficiency in survival craft and rescue boats 1893901 19.05.2022 19.05.2027
Advanced fire-fighting 1895591 17.05.2022 17.05.2027
Medical care course
Medical first-aid 1.05.0262/2022 24.05.2022 24.05.2027
SSO - Ship security officer
SSS - Ship security staff 1899995 26.05.2022 26.06
BTM / ETM ( Bridge / engine team management)
Ships carrying dangerous and hazardous cargoes
Maneuvering & ship handling
ECDIS (electronic charts)
ISM Code
AIS
DP-operator
Certificate of health 51953044 27.02.2023 27.02.2024
Vaccination / Re vaccination against yellow fever 02.07.2010
CERTIFICATES OF RATINGS (WORKING EXPERIENCE MUST BE DECLARED IF THE DOCUMENTS ARE MISSING)
Rating Forming Part of a Navigational Watch (ABLE SEAMAN)
Rating Forming Part of a Engineering Watch (MOTORMAN)
Boatswain
Cook « » grade
FITTER / WLD « » grade
Electrician
Pumpman
-----------------------
[pic]
PHOTO
1 сентября, 2017
Вадим
Город
Калининград
Возраст
52 года (26 сентября 1972)
24 июля, 2023
Надежда
Город
Калининград
Возраст
54 года (27 августа 2025)
25 июля, 2023
Оксана
Город
Калининград
Возраст
55 лет (27 августа 2025)