SPAM APR 16 SPECIAL HOUSING UNIT RECORD U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEW YORK MCC (Institution) Inmate Name: EPSTEIN, JEFFREY EDWARD Reg. ese. 76318.054 Teamtaseworker UNASSIGNED ADMISSION Regular UM . Ma:M. UNIT MANAGER Cell' MO ' Violation Date Time PENDING CLASSIFICATION 2019-07-07 19:20 or Reason: Reed: Real: AdmMance Date Time Authorized: Rel.: Rel.: Pertinent Information: N/A Separation Information: NIA Special Housing Unit Cell Number: Z05-124 LAD Inmate Is In: Is Inmate on Medication: N Date Shift Meals SH Exercise Out of cell lime (total) Comments Medical Staff Sign OIC Signature B D S Morn Day Eve 0745.2019 Morn v Day Eve Morn Day Eve Morn Day 07.114019 Eve Mom Y 07.11.2019 Day Y N Ref See 2nd page 07.11.2019 Eve y 07.124019 MOM Y 07.124019 Day y an 2nd page 07.124019 Eve y 07.114019 Morn v a .- 07.134019 Day v 07.11.2019 Eve v DS: Medical Department Notified: AD AD Status 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 Ubrary,(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 Stan and End (i.e., 0930 -1030 hrs) in OW 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 tom replaces BP•292(52) dated AUG 2011. EFTA00036587

Day shift comments: 07-11-2019 Health: Voices no medical complaints. Day shift comments: 07-12-2019 Health: Voices no medical complaints. EFTA00036588