9940292 A99 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK—MCC (Institution) Inmate Name: Reg. EPSTEIN, JEFFREY EDWARD No. 76318.054 Tearnicaseworker. UNASSIGNED ADMISSION Regular Unit: AEON. Cell: e UNIT MANAGER X 6473 AF.O Violation Date Time or Reason: eed• N/A Recd N/A N/A Admittance Date Time Authorized: N/A Rel.: NIA Ret NIA Pertinent Information: N/A Separation Information: N/A Special Housing Unit CeM Number: 205-124LAD Inmate Is In: WA Is Inmate on Medication: Medical Department Notified Date Shift Meals SH Exercise Out of cell time (Total mlevhns) Comments SMedical taff Sign OIC Signature El D S Mom Day Eve I 07-08.2019 I Mom Day Eve Morn Day Eve Morn Day Eve 07414919 Morn v 07-11.2019 Day v N Pr See 2/92 pope JOAQUIN. YSIJAIL, 0741.2019 Eve v 07.124019 Morn v 07.124019 Day y sin mo per SOUK YSIMEt. 07.124019 Eve Y I I 07.114019 Morn Y 07.134019 Day y 07.154019 Eve Y N/A OS: N/A WA ADStatus EXPLANATORYNOTES:Pertinent Info: -.e.. Epileptic: Diabetic; Assaultive: etc. Meals/SH: Shower - Yes co; No (N). Refused (R)Out-of-Cell Time (LL) Law Library.(LV) Legs Visit. (U) Unit Team. (P) Psychology. (E) Education (H) Haircut. (C) Chapel. (R) Recreation. (X) Property Issue. C/) (M) Medical (C) Court. (O) Other— Yes (Y) Y applicable / Enter Actual TornePerlod Start and End (i.e.. 0930 —1030 his) in Out of Cm Time Monk. 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 minima the record sheet must be signed at least once each day by the medical provider. Comments: i.e.. Conduct. Atttude, etc. Additional comments on reverse side must include date, signature. and title. OIC Signature: OIC must sign all record sheets each slit. (OIC - Unit Officer) POP PrescAbed by P5270 This bin replaCes SP-292(52) dated AUG 2011. EFT