Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Lp 5 -c Register #: li4 9°Ol l- G54 Institution: Date Watch Began / Ended ONLY ITEMS ALLOWED: E 2 9-) CU "O as :O eri V) V) V) To be completed by Chief Psychologist at conclusion of watch: Booklet of Suicide Mattress SWCL - INMATE EFTA00140484

STAPLE LOCAL PROCEDURES HERE Check one of the following: 0 This is the initial log book for this suicide watch. Enter date and time watch began: 0 This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. EFTA00140485

Suicide Watch Observation Log Name of inmate — 1 „ „._ on watch: 4JY -it i ( 1 Reg Si: 143 10• 054 Date: -1 23e Time Observations: Briefly note your observations. Initial all entries. Initials j:LjO M Sr e‘1514 ,tudv) -JO S IA it i &E cell #14 o — l ' LIS" ,A% ii Oki ge- a ---O--L 2. a int'l % A, 2.--i i frife.i. .— 2 0., fr. . .5 II , me ( ( • k ei J i .6 tel( 2 5 t's 01 S cehii wi (0? ...3 -fill iw y h (-Cu —44 S. f' -I 0 a Afpr 2' 434 t f g NCI a it ov F 43 Avi Cr Y1 u. 6e 13 -'5---- 3. 'c 4-4 kw!). fie Iti fd 9 604, Ci El A 6( 0 3 sts g tii F-e3 Lk.r A., : 7d-e F.- W' S-b-p..all 44— .&A - -1f--( 4._..tm. -14,1 I eihp rlt tow S 4 A.At L.5 -Atte 0 — O C e f r grim- w C i ,k, k4 .. g r itty' m >\1-1k _ A " IAA Note to all observers: Legibly print gnd sign your name at the beginning of your shift. 1 EFTA00140486

Suicide Watch Chronological Log Staff Suicide Watch Observers Only Name of inmate on watch: Ep54-e".4"). J. Register #: 1. Co Sta-ma y Institution: MOT', New \leo< Date Watch Began / Ended July 23,2014 J-v)/ iq To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - STAFF EFTA00140487

STAPLE LOCAL PROCEDURES HERE Check one of the following: This is the initial log book for this suicide watch. Enter date and time watch began: July 23)20in a+ (.MOAN This a continuation log book for this watch. . . „ Eriter date and time this watch book was Instructions to Observer: Document your observations every )5 minutes. Legibly print and sign your name at the beginning of your shift. EFTA00140488

Ep,54e_in Suicide Watch Observation Log Name,. of inmate on watch: Reg #: -q(13 lb- (-1524 Date: ' 23 Ici Time Observations: Briefly note your observations. Initial all entries, Initials I .. -40 Am 1 n mck bvot hi- riwin fo Su ir ide Cel I -WI- l '. zi5Akq1 inrndfe 1\lio on bed j et 2,0DAm Inmoi-e , i-i-finr1 On bed +0 lki09 2. 1.5A ,/i inrn-feOicti-eolli 5 CeIII11C11-e. -ked, -I-o Mika) 2'.30Am t nrrOk 3i-\-iins on bad .41 i cnio remember vvh-11- happened, 2...i54,4 Inmafe 6i-i-l-ir9 on Led 3..apayi InmcAt_ 6 HA; o bed ai5A0 <&...5 piefures a i rynl-42. 5.30Am Inrmi-e. oi+-i ir3 on be(' 5',45Am Inmafe 6i-ftin3 on bed r 42. ()DAM In cro+e, L54-ting on bed 4', 15Ani I nino4-e Lli4-1-in5 Dr) bed 4..30Am nern-i-e. ,5}nroin3 co- door -fakir-9 4-45Am Inc/Yale. c_540rrlin9 04- door -1-allcie-9 5*.COArvi Inrno+e 6 i++Ms on ixd 5:15Am i nrnak Olardi a+ door 5'.,3c)Awi Inmak 6-11-Indi no 04 door 5',45ANI .. Iniena-le cSkinriing c# door (x)..DOPktvi Intna-te —1-lartlino al- cictr Co'. I5Am Int-ne. c,54ni liro 04- door 41?:,3oAt,4 In +e (_54anOiro cl+ doof (0'.45Am Incralt., Olan6ins Cli- (k)nr 4'.00,00.4 inmcil-e- ,NOnain9 a4- Ow' Note to all observers: Legibly print and sign your name at the beginning of your shift. EFTA00140489