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Page 2696 BP-A0292 APR 16 U.S. DEPARTMENT OF JUSTICE SPECIAL HOUSING UNIT RECORD FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) 76318-0584 inmate Name: EPSTEIN, JEFFREY EDWARD Reg. No. os ee UNASSIGNED ADMISSION Regular Unit: Violation Date N/A Rec'd: NIA or Reason: Re: = FF Ce i Date Time Admittance i NIA si NIA Authorized: Rel: OR Pertinent Information: ;, ia Separation Information: a =1 NIA NIA Special Housing Unit Cell Number 220t24LAD inmate Is as: saeeeeeene seen, Status i NIA Is Inmate on Medication, N/A Medical Department Notified: 0 in Out of cell time Medical Date shit |___Meals__| SH | Exercise Saraiva Staff Sign OIC Signature B|D|S ‘(Total min/nrs) __|_ == : = PONE EIT) o7-14-2019] Morn | ¥ | | MG); (D7 NE) __| ——__—— =a o7-14.2019 | Day Y N | Ne | 07-14-2019 | Eve | y | oN [No E ——- BMG! (DMT }C) 07-15-2019 Morn ¥ (BFC) 07-15-2018 | Day Y ¥Y | No 01:00 See 2nd page 07-15-2018| Eve ¥ Ne O7-16-2019 | Morn ¥ ] 07-16-2019) Day y || - See 2nd page —— — —_——— _—_—— 07-16-2019 | Eve Y No o7-17-2019 | Morm ¥ 07-17-2013 | Day an ie; y | Ref 04:00 See 2nd page 07-17-2018 | Eve | ¥ Neo 07-18-2019 | Morn ¥ 07-18-2019 Day —r ¥ Nn | Ref | See 2nd page o7-16-2019 | Eve Y No T 07-19-2019 | Morn ¥ | Brame) ast k | jit 07-18-2018 | Day Y y | 00:15 ~ | See 2nd page ezos| Eve | | | ¥ 07-20-2019 wom [y| | | | | 07-20-2019) Day ¥ Te a = 07-20-2019 | Eve y] Nn [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, (O) Other — Yes (Y) if applicable / Enter Actual Time Period Start and End (1.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- 00026352