Free Response in Opposition to Motion - District Court of Arizona - Arizona

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Case 2:O2—cv—O2252-JAT Document 275-2 FiIed10/26/2005 Page10f2

NOTIFICATION OF CHARGES & RULE VIOLATION
U ”RISONER'S NAME Mikkelsen, Kelley· # 11996OA DATE: lOg1l{O1 3
.ou are hereby notified that it is alleged that you have committed the following rule violations.
Por este medic, se le notifica a usted que se alega que usted ha cometido las siquientes ;
violaciones.
RULES In·an manner oossessinq alcoholic beveraces or (U) MAJOR _
REGLAS · _ _ MAYOR
Unauthorized drugs (4.D.1.i. [ I . ` Q
(X) SERIOUS
· same
INCIDENT INFORMATION (INFORMACION DEL INCIDENTE}
DATE 10g11gO1 l _
TIME 1805 {date & time of incident) 5
eUnit or area Outer door 510C
Facts on which chargeis} are based on Prisoner Mikkelsen admitting to taken 3 Valium crior
_ to returning to work furloudh, his prescription called for 1 tablet per 12 hours. also his
ehavior was sluggish as was his speech ‘ · · Z
l immediate Action Taken moved to RD—2 & placed in Disciplinary Sanctions l
Maximum Penalty 10 days disciplinary sanctions with loss pf privileges `
' (Pena Maxima) · ‘
Recommendations 3 days disciplinary sanctions with loss of privileoes i
(Recomedacion) ( _ I T
` Officer Si-gnatul-Y€ 23/_'
Supervisor's Recommendations. ` - ‘
. - T Jéi ¤.¢1q_3..,_ I
Supervisor‘s Signature ‘ wfE¤ D# -
YOU HAVE TEE RIGHT TO REQUEST A DISCIPLINARY HEARING OF THE ABOVE CHARGES.
SUCH A REQUEST MUST BE @E IN WRITING TO THE FACILITY ADMINISTRATOR WITHIN
FORT?-EIGHT (48) HOURS.
_ Usted tiene el de:.-echo de pedir un Audiencia. Dicipinaria de los cargos axriba
mencionados. Dicho pedido debede sez: hecho por es‘cz·:i.to al Administrador de
. ._ a Facilidad dentro de cuarenta y ocho (48) horas-
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7""` U _ Ei-SET. MO. U
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Case 2:O2—cv-02252-JAT Document 275-2 ”`FHed“ ‘II Page 2 of 2 E

Case 2:02-cv-02252-JAT

Document 275-2

Filed 10/26/2005

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Case 2:02-cv-02252-JAT

Document 275-2

Filed 10/26/2005

Page 2 of 2