APPLICATION FORM

PERSONAL DESCRIPTION AND INFORMATION

Family Name : Basenko Name: Dmitriy
Date of birth: 18.06.1968 Place: Nakhodka, RUSSIA Nationality: Russian
Passport: 72 3597071 issue date: 07.03.2013 Expiration date: 07.03.2023
Phone +79147134965 E-mail basdmitriy@bk.ru Skype:Den687 Den687
Civil Status: Married Nbr of Children: two
Next of kin: Tatyana Basenko Relation: wife
Nearest airport: Vladivostok
Education: Far Eastern Higher Engineering Marine Academy
Speciality “Operation of marine power plants” Vladivostok. Russia. from 09.1985 to 08.1993
Language: Russian, English

License Number Issue date Expiry date Country

National-COC 3025500205 18.09.14 05.08.19 Russia
Endorsement for Oil and Chemical tankers 3025520119 18.09.14 24.07.19 Russia
Russian Seaman’s Book MK 0098621 05.02.13 No date of Russia
expiry
Seafarer’s identity document RUS 0393798 12.12.17 11.12.22 Russia
Cayman Island LAP /Officer KY044432 15.04.18 05.08.19 United Kindom
Flag State Endorsement (Cayman Island) KY036585 01.10.15 05.08.19 Cayman Island
Flag State Endorsement (Liberia) 984395 20.11.14 05.08.19 Liberia
National-Tankerman Oil 3025520119 18.09.14 24.07.19 Russia
National-Tankerman Chemical 3025520119 18.09.14 24.07.19 Russia
Basic Safety Training (Sec A-VI/1,Tab A-VI/1-1, A-VI/1-2, A-VI/1-3, A-VI/1-4) 0443770 08.08.14 07.08.19 Russia
Advanced Fire Fighting (Sec A-VI/3, Tab A-VI/3) 0444659 11.08.14 10.08.19 Russia
Proficiency in survival craft, rescue boats (Sec A-VI/2,Tab A-VI/2-1) 0445507 12.08.14 11.08.19 Russia
Medical First Aid, (Sec A-VI/4, Tab A-VI/4-1) 0446248 15.08.14 14.08.19 Russia
Basic training for Oil and chemical tanker cargo operations (Sec A-V/1- 0446932 23.07.14 22.07.19 Russia
1 Tab A V/1-1-1)
Advanced training for oil tanker cargo operation ( Sec A-V/1-1 Tab A-V/1- 0447287 25.07.14 24.07.19 Russia
1-2)
Advanced training for Chemical tanker cargo operation (Sec A-V/1-1 Tab 0097875 30.07.14 29.07.19 Russia
A V/1-1-3)
Designated security duties (Sec A-VI/6, Tab A-VI/6-2) 0458184 06.08.14 05.08.19 Russia
Engine Team and Resources Management 2/2017 13.01.17 13.01.22 Russia
Crude Oil Washing Operation/Inert Gas System 172/14 25.07.14 25.07.19 Russia
Framo Training Certificate/Course M03 On Board Training 2578 22.03.15 22.03.20 Norway
Marpol Compliance Course/Certificate 020-18072015 18.07.2015 Russia
Excellence in Safety 2/Procedure Compliance & Situational Awareness SAFEX2005- 19.05.2016 Philippines
190516MNL

Med-examination certificate 23.08.18 23.08.19 Russian Federation

Med. - Yellow fever 978 Moscow 25.05.16 Life time Russian Federation
Passport 72_3597071 07.03.2013 07.03.2023 Russian Federation

CES 6.0.0 92% 14.12.18

Planned Maintenance Systems : AMOS (old version); BASSnet

American visa type C1/D 20182820090004 10 oct 2018 08 oct 2020 Vladivostok
 PREVIOUS SEA SERVICES
Rank Vessel Name Vessel Type DWT Engine Type/kW Period Length of Ship Owner/
(DD/MM/YY) Time Manager
Onboard
From To
Sulzer
Oil/Chem 5RND76M/8500
2ndEng Stolt Protector 39782 15.01.2008 08.05.2008 3m 23 days Stolt Tankers B.V.
Sulzer
Oil/Chem 5RND76M/8500
2ndEng Stolt Protector 39782 18.09.2008 07.01.2009 3m 25 days Stolt Tankers B.V.
Sulzer
Oil/Chem 5RND76M/8500
2ndEng Stolt Protector 39782 25.04.2009 22.08.2009 3m 27 days Stolt Tankers B.V.
Sulzer
Oil/Chem 5RND76M/8500
2ndEng Stolt Protector 39782 28.12.2009 14.04.2010 3m17days Stolt Tankers B.V.
MAN B&W Stolt Gulf Parcel
2ndEng Stolt Gulf Mirdif Oil/Chem 46011 5S60MC-C/11300 28.06.2010 07.11.2010 4m10days Tanker LTD
2ndEng Stolt Ocelot Oil/Chem 23324
Makita-MAN
B&W7S42MC/717 Stolt Tankers B.V.
5
28.01.2011 18.06.2011 4m21days
2ndEng Stolt Ocelot Oil/Chem 23324 Makita-MAN 4m14days Stolt Tankers B.V.
B&W7S42MC/7175 11.10.2011 23.02.2012
2ndEng Stolt Courage Oil/Chem 32858 Mitsui-MAN B&W 3m24days Stolt Tankers B.V.
6S50MC-C/7980 22.06.2012 13.10.2012
2ndEng Stolt Gulf Mirdif Oil/Chem 46011 MAN B&W 4m29days Stolt Gulf Parcel
5S60MC-C/11300 24.04.2013 22.09.2013 Tanker LTD
2ndEng Stolt Sisto Oil/Chem 46011 MAN B&W 5m9days Stolt Gulf Parcel
5S60MC-C/11300 07.02.2014 15.07.2014 Tanker LTD
2ndEng Stolt Courage Oil/Chem 32858 Mitsui-MAN B&W 5m10days Stolt Tankers B.V.
6S50MC-C/7980 17.11.2014 26.04.2015
Cheng Stolt Facto Oil/Chem 46011 MAN B&W 5m19days Stolt Tankers B.V.
5S60MC-C/11300 11.08.2015 30.01.2016
Cheng Stolt Facto Oil/Chem 46011 MAN B&W 4m19days Stolt Tankers B.V.
5S60MC-C/11300 07.06.2016 22.10.2016
Cheng Stolt Sagaland Oil/Chem 44044 Kawasaki-MAN 4m24days Stolt Tankers B.V.
B&W 7S60MC-
C/11060 12.03.2017 04.08.2017
Cheng Stolt Sagaland Oil/Chem 44044 Kawasaki-MAN 4m9days Stolt Tankers B.V.
B&W 7S60MC-
C/11060 19.12.2017 25.04.2018