NOMINATION FOR M/ V:
Position applied for: Electrician Date: 04. 04. 2011
Surname: Burlachenko First Name: Valeri
Date of Birth: 29. 07. 66 Place of birth: Russia
Nationality: Russian Departure airport : Palanga
Home address: Latvien. Liepaja. Silku street 12 apart 4
Tel.:+ 371 29776463  Marital status: maried
Number of children under the age of 18: 1
Next of Kin / Relationship /Address: Diana Dmitrieva/ Wife/ The same
Marine college: Liepaja Marine college
E- mail @ Takor196@inbox. lv

CERTIFICATES:
Description Number Place Issue Expiry
License of Competency
G r a d e: Electrician 37/ 11 Riga 11. 03. 2011 10. 03. 2016
Passport Latvian
Citizen Alien LZ3013234 Liepaja 20. 02. 2008 19. 02. 2013

Personal survival techniques, safety and social responsobility 33- 07/ 11 Liepaja 04. 03. 2011 unlimited
Fire prevention and fire fighting 33- 07/ 11 Liepaja 04. 03. 2011 unlimited
Elementary first aid 33- 07/ 11 Liepaja 04. 03. 2011 unlimited
Medical Certificate Vc- 7772 Liepaja 11. 02. 2011 11. 02. 2012
PREVIOUS SEA SERVICE:

26. 07. 1993 24. 03. 1994 electrician SR- 936 Supply ship 2096 dwg
01. 10. 1990 26. 06. 1992 motormen BGK 171 Supply ship 128 dwg
16. 01. 1990 01. 10. 1990 electrician Lag Dry cargo 1850 dwg
01. 05. 1989 16. 01. 1990 electrician GS- 301 The researcher 1190 dwg
18. 06. 1985 01. 05. 1989 electrician Lag Dry cargo 1850 dwg