> } ; f t Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: a) 1 ic . (9) Suic To be completed by Chief Psychologist at conclusion of watch: Booklet \ of ji . Qa 2 _—?/ Ww @ = a. Register #: (eo) = — WY QP 2 7) 16314 -OSt = 2530 WMoecrgy Institution: ee c © ce wAmMe s .// <a EeowwY >~ SEG Date Watch Began/Ended =! 22a z 5 '5 6 nn a SWCL - Tampons or Foam Belt/Napkin § c o 2 © 2 cz: . 9 a Oo ae Cc 7) Oo ssc “A x INMATE EFTA00110492

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STAPLE LOCAL PROCEDURES HERE Check one of the following: 0 This is the initial log book for this suicide watch. Enter date and time watch began: _ ra This is a continuation log book for this watch. Enter date and time this watch book was initiated: -23-04 1. d0am © Instructions to Observer: Document your observations every _\Sy minutes. Legibly print and sign your name at the beginning of your shift. EFTA00110493

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PP37 OX Page 1 of | —— ee ) NYMBJ 531.01 * INMATE HISTORY * 4. 67-24-2019 PAGE 001 OF 001 * MED DY ST * 12:32:30 REG NO..: [76318-054 NAME....: EPSTEIN, JEFFREY EDWARD CATEGORY: [MDS FUNCTION: [0IS FORMAT: | FCL ASSIGNMENT DESCRIPTION START DATE/TIME STOP DATE/TIME NYM NOT MED CL NOT MEDICALLY CLEARED 07-06-2019 2124 CURRENT NYM SUIC WATCH SUICIDE WATCH 07-23-2019 0140 07-24-2019 0845 G0005 TRANSACTION SUCCESSFULLY COMPLETED - CONTINUE PROCESSING IF DESIRED * 7/24/2019 EFTA00110494 https://bop.tcp.doj.gov:9049/SENTR Y/J1PP160.do

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= Suicide Watch Observation Log Name of |nmate | time | Observations: Briefly note your observations. Initial all entries. LB ikea | rtd St DAMM a ot. 27 ister oa aut Z Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110495

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Suicide Watch Observation Log Name of Inmate on watch: <4 Reg #: 16 IK OS F dDate:O7- 23 4G Time Observations: Briefly note your observations. Initial all entries. rs : Jam AHA = go 129M) \-47707741/ war NSF 4A GUE 4 g | A Pr ASS C 2 at 7 sa Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110496

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Suicide Watch Observation Log Name of Inmate => —a watch: Date: 7 2S / a Q Observations: Briefly note your observations. Initial all entries. an Mn \Zrraerk Piet eas sae (O4San tase Eras tim a py since | o£ Note to all observers: Legibly print and sign your name at the beginning of your shift. 3 EFTA00110497

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(225 PoN5.8. AC 1) UbsTeice Cyl lM 6 GPS EN EN oul US Dir __ GPSFEN “ins ebvrad Gaew C6cACm | im GPSlan \S Trice, aout Ce — 20 oo tr CPSled 15 Winn tim SHEN ie 20; tha Epo lens 1S Lacicin'o Gud SCrenw 20; De EP ley SS tne Seaxt px DDHS 2px eS Zliv _—_— g.(S , at bey: 20 | -. WANS - 2\ 530 tO CSL. iS tek WO Bot j4e0 RP ys ics. a n — OME PGC Ween —_— LL. ow wn CPSters DEC OG TO 1441 domn Q2zns5 72 2lus Dim ¢ zr is. TeX Lim EPsew BECEANS fo Re Mane 22:3 Li Ef S32. GOe&e Be Sood Zems | tim 663, Deas fu & ToePZ] %e ENO Suet Ly t Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110498

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Suicide Watch Observation Log Observations: Briefly note your observations. Initial all entries. (oeynsw tal i He suid sich of —xFte BSS ae eee ea peace sre Wels On, - a PATEL Ty<hcS Peiteg sega wet VO a JV NYS eae s Ean ee oa tee ee 4 on watch PSTEMHS = 7) YE3I “pate V/23 (Gq _| Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110499

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Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110500

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OS ¢: avyesis +5 be Sleehiaa Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00110501