Safety and Environmental Management System

SEMS Section 6
Rev: 05
01 July 2015

Pre-Employment Checklist

Attachment 6.5

CREW NAME

CREW ID

INDONESIA

VESSEL NAME

RANK

OILER

STCW Certificate

Number

Issue Date

Expiry Date Offshore Certificate

C.O.C

BOSEIT (with EBS)

GOC/GMDSS

HUET

SSO (ISPS CODE)

RIGGING & SLINGING

BTM /BRM

FAST RESCUE BOAT

ERM

FOOD HANDLING

BASIC SAFETY
TRAINING
SURVIVAL CRAFT &
RESCUE BOAT
ADVANCED FIRE
FIGHTING

6200098943014710

27.05.16

H2S AWARENESS

6200098943044710

14.06.16

DP BASIC

6200098943060116

11.04.16

DP ADVANCED

MEDICAL CARE
RATING
WATCHKEEPING

Issue Date

Expiry Date

Number

Issue Date

Expiry Date

Number

Issue Date

Expiry Date

DP OPERATOR
6200098943420216

04.06.16

SECURITY
620009894320116
DESIGNATED DUTIES

11.06.16

Number

OFFSHORE SAFETY
PASSPORT

29.06.16

SECURITY TRAINING 620009894320116

Travel Document

Number

Issue Date

Expiry Date VISA

PASSPORT

B 3692748

21.04.16

INDIA MOHA

SEAMAN'S BOOK /
CDC

C 061151

21.05.14

INDIA NED PASS

PCC (POLICE
CLEARANCE)

Flag State Licence

Number

Issue Date

Expiry Date

COC ENDORSEMENT
GOC

NOTE:
* Indicate N/A, if certificate is not applicable
* Seafarer must bring along all original certificates when joining vessel

SIGNAUTRE
NAME:
RANK:
DATE:

Medical Fitness
Certificate
PRE-EMPLOYMENT
MEDICAL
OFFSHORE MEDICAL

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Section 6