BP-AD292 APR 16 U.S. DEPARTMENT OF JUSTICE ee) NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No,_76318-054 Teamicaseworker. Regular Unit: SUNT vcr a $ Violation PENDING CLASSIFICATIO! Date Time orReason:_PENDING CLASSIFICATION age «2019-07-29 pecs: _ 1224 Admittance Date Time Authorized: Le Rel.: Rel.: Pertinent Information: NA Separation Information: ’ Special Housing Unit Cell Number: 204-206LAD Inmate Is In: DS: AD AD Status Is Inmate on Medication: ¥ Medical Department Notified: . Out of cell time Medical Date Shift Meals SH | Exercise Comments Staff Sign OIC Signature |B) Dd. S| {Total min/hrs) | Morn | Day Eve 07-29-2019 Morn | ¥ Day o7-28-2019| Eve | | YIN 07-30-2019 Morn | Es orao2013) Day | | ¥ | | N |Ref | [See 2n¢ p20 | ES 07-30-2019 | Eve Y No es —EE———EE—————E————_—————Eoe——E——E 07-31-2018 Mom | as 07-31-2019 | Day Y y | 0&3007-30 0 02:00 See 2nd page | i 07-31-2019 | Eve Y ce Ce! 9201-2019] Morn ly ee 06-07-2019; Day | | y | N | Ret | See 2rd page| TT [es 06.07.2019 | Eve y | No ee 06-02-2019 Morn | ¥ | eee! 06022018; Day | | vy (|Y [Ne | 01:00 [See 2nd 390 | mecz2t | Eve t v | no Dn 06-03-2019 | Morn Y Pe 06032019 Day | |v | | a 06.03.2019 | Eve y| N [No 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. EFTA00036582

--=PAGE_BREAK=--

07-30-2019 07-31-2019 08-01-2019 08-02-2019 Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints. Day shift comments: Health: Voices no medical complaints. EFTA00036583