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AP-Ad292 APR 14 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS InmateName: EPSTEIN, JEFFREY EDWARD NEWYORKMCC | {Instituiion) 76318-0054 Reg. Na. [sanveasawerter UNASSIGNED ADMISSION Violation or Reason: Date Admittance Authorized: Date Rec'd: Rel. TA Pertinent Information: Ny Regular Unit: As CUN'T MANAGER aR cu: ASO Time MA Rec'd: NA Time i NIA Rel: N Separation information: ¥ P 205-124LAD Special Housing Unit Gell Number: ade Inmate | [n: Nie OSs: Nie AD Status N/A Is Inmate on Medication: Medical Department Notified: Date Shift Meals SH | Exercise Out of ceil time (Total min/hrs) Hl : Medical . Staff Sign Ole Signature Comments 7-14-2019) Morn ¥ | a7-14-2019 | Day ' | ¥ N [No o7-14-2019| Eve ¥ N | We 07-15-2019 | Morn ¥ | o7-45-2019 Day y 01:06 See and pags “ar-ts2ois | Eve “| oy Na O7-16-2014 Morn "py -16-2019 Sae 2nd page Day f a7-16-2018) Eve ¥ No ar-i7-2019| Mam | ¥ ar-i7-2019] Day ¥ y | Ror o1:00 See 2nd pags az-ty2e3| Eve ¥ No 07-48-2019 | Mom ¥ a7-15-2019 Day Ys! uN. | Ret See 2nd paga ay-1a-2018| Eve , ¥ Ne 07-19-2018) Morn y i “or-is-20191 Day ¥ ¥ an: 15 See 2nd page o7-19-2019] Eve i ¥ 07-20-2098 | Morn ¥ I . | a4 o7-20-2018 ‘Day or-eazoie| Eve ¥ |] oN [Ne EXPLANATORYNOTES:Pertinent (nfo: iLe., Epileptic; Diabatle; Suicidal; Assaultive; etc. Meals/SH: Shower - Yes (¥} No (N} Refused (RjOut-of-Cell Time: {LL} Law Library.(L¥) Legal Visit, (U) Unit Team, {P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (%} Property Issue, (¥) Visit, (Ml) Medical, {C) Court, (G) Other - Yes (Y) if applicable / Enter Actual Time Period Start and End (.e., 0930 — 1030 hrs} in Out of Call 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 ance each day by the medical provider. C side must include date, signature, and litle. OIC Signature: OIC must sign all record PDF Prescribed by P5270 comments: i.e., Conduct, Attitude, etc. Additional comments on reverse sheets each shift. (OIC - Unit Officer} This form replaces BP-292(52) dated AUG 2011. DOJ-OGR- 00024608