BP-AD292 APR 16 U.S. DEPARTMENT OF JUSTICE SPECIAL HOUSING UNIT RECORD FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg, No__.76318-054 Toamicaseworker. UNASSIGNED ADMISSION Regular Unit: AsO. UNIT MANAGER II, A&O Violation PENDING CLASSIFICATIO: Date Time or Reason;_PENDIN ‘ATION Recig: 2019-07-07 Roce: _ 1220 Admittance | Date Time Authorized: Rel.: Rel.: NIA Pertinent Information: Separation Information: NA Special Housing Unit Cell Number: 206-124LAD Inmate Is In: DS: AD AD Status Is Inmate on Medication: N Medica! Department Notified: Out of cell time Medical Comments Staff Sign Date Shift Meals SH | Exercise B' DS {Total min/hrs) OIC Signature Morn Day Eve Day 07-11-2019 | Morn Y 07-11-2019 | Day Y N | Ref See 2nd page 07-11-2019 | Eve | Y 07-12-2019 07-12-2018 | Day Y See 2nd page 07-12-2019 07-13-2019 07-13-2013 | Day Y 07-13-2019 EXPLANATORYNOTES Pertinent Info: i.e., Epileptic; Diabetic; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (Y): No (N); Refused (R)Out-of-Cell Time: (LL) Law Library,(LV) Legal! Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (0) Other — Yes (Y) if applicable / Enter Actual Time Period Start and End (i.e., 0930 — 1030 hrs) in Out of Cell Time Block. Medical: Medical providers will sign the segregation log each shift and the record sheet each time the inmate is seen by a medical provider. At a minimum, the record sheet must be signed at least once each day by the medical provider. Comments: i.e., Conduct, Attitude, etc. Additional comments on reverse side must include date, signature, and title. OIC Signature: OIC must sign all record sheets each shift. (OIC - Unit Officer) PDF Prescribed by P5270 This form replaces BP-292(52) dated AUG 2011. EFTA00036587

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Day shift comments: 07-11-2019 Health: Voices no medical complaints. Day shift comments: 07-12-2019 Health: Voices no medical complaints. EFTA00036588