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Page 997 BP-A0292 APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS (Institution Inmate Name: EPSTEIN, JEFFREY EDWARD . Reg. No. 76318-054 b)(6) b}(6); (bP MC) Team/caseworker: Regular Unit: SUNT MGR EON) ‘ad Cell: 5 Violation ik Date Time or Reason: Rec'd: N/A _ Rec'd: oe Admittance Date Time Authorized: Rel.: i Rel.: ini Pertinent Information: Bu Separation Information: Li Special Housing Unit Cell Number: corel Inmate Is In: NA DS: NA AD Status Is Inmate on Medication: Medical Department Notified: Eo Out of cell time Medical Date Shift 5 a 5 SH | Exercise —s Staff Sign OIC Signature (Total min/hrs) — 08-04-2019 | Morn 4 Tb )(6); (DMT NC) 08-04-2019 | Day Y 08-04-2019 Eve | Y 08-05-2019] Morn | ¥ 08-05-2019 | Day Y 08-05-2019 Eve ij 08-06-2019 Morn Y 08-06-2019 | Day y 08-06-2019 Eve ¥ No 08-07-2019 Morn ¥ 08-07-2019 Day ¥ 08-07-2019 Eve Y No 08-08-2019 | Morn ¥ 08-08-2018 | Day Y 08-08-2019 | Eve Y 08-09-2019 | Morn ¥ 08-09-2019 Day ¥ 08-09-2019 Eve ¥ Morn Day Eve SSS SE SS SS SS SS Se SSS SSS SSS SSS SSSSaSaSaaaaaa—— 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, (O) 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. DOJ-OGR-00025241