4 An amended Agreed Statement of Facts was tendered which relevantly reads as follows:
2) At all material times, Twynam Investments Pty. Limited [ACN NO: 000 573 213] was a company duly incorporated with its registered office at Level 7, 17 - 19 Bridge St, Sydney, in the State of New South Wales, being an employer, at Gundaline Farm Centre, Gundaline Station, Sturt Highway, Carrathool in the said State.
3) The Defendant operates over fifteen properties in the State of New South Wales and is one of the largest cotton, rice and wheat growers in Australia.
4) The Defendant, at all material times, operated a farm at Gundaline Farm Centre, Gundaline Station, Carrathool, in the State of New South Wales ("the property").
5) The Defendant, at all material times, employed a number of workers, including Raymond Milne ("Milne"), to work at the property.
6) Milne was employed by the Defendant as a farm hand from about 5 April 1993, becoming a permanent employee as an intermediate farmer/plant operator on 30 June 1998 and was employed by the Defendant in that position on 26 September 2001 ("the accident date").
7) As part of his duties, Milne was required to inspect and maintain the rake machine.
8) The rake machine was owned by Twynam (Gundaline) Pastoral Company Pty Ltd and had been purchased from Batescrew Sales Pty Ltd in about 1986 and used at the property for approximately 15 years prior to the accident date.
9) The rake machine is situated over a culvert that traverses an irrigation channel on the property, the channel being approximately two metres wide at that point. Water from the irrigation channel enters a pump that removes water from the channel to other locations. The rake machine is designed to remove debris from the irrigation channel in order to prevent it from entering the pump.
10) The rake machine has scraper bars hydraulically driven by chains on either side of the rake machine to carry debris up a fixed steel plate. The scraper bars, located about 1.5 metres apart, move through the water and use metal "fingers" to collect debris which is then deposited onto a conveyor running across the channel, which then deposits the debris into a pile on the western side of the bank.
11) On the accident date, a grid mesh walkway was positioned to run across the irrigation channel passing under the top portion of the rake machine ("the walkway"). A person standing on the walkway could access the moving parts of the rake machine, in particular the scraper bars.
12) At some points on the rake machine, accessible to a person standing on the walkway, the scraper bars pass a number of "C" section cross braces welded on the underside of the rake machine. As the scraper bars pass the braces a nip point is created.
13) The scraper bars are moved by hydraulic chains that are lubricated by oil dripper cans located on either side of the rake machine ("the drippers").
14) On the accident date, Milne commenced work at approximately 7.30 am. He met with the manager of the property, Chris Barry ("Barry") and another employee of the Defendant, the equipment overseer, Graham Hunt ("Hunt") at the workshop on the property.
15) At that meeting, Barry requested Hunt and Milne to inspect the rake machine that day and undertake any maintenance that may be required in order to make the rake machine operational. The servicing of the rake machine was usually carried out on a daily basis during the season between September and March each year. On the accident date, the service of the rake machine was to prepare it for use in the upcoming season. Until the date of the accident, the rake machine had not been in operation since the previous season. Part of the maintenance required for the rake machine was to ensure that the drippers were working.
16) Hunt and Milne attended the rake machine in the morning on the accident date to undertake maintenance. Around lunch-time both Hunt and Milne left the rake machine and Hunt proceeded to go for his lunch break.
17) At some point in the afternoon, Milne returned alone to the rake machine. Milne later told the Ambulance Officer that the rake machine was operating while he was checking the machinery. He was struck on the back of the neck and shoulders by a scraper bar which subsequently jammed his neck and shoulder between the moving scraper bar and the fixed "C" - section cross brace.
18) As a result of the incident, Milne received severe injuries to his neck that caused him to fall onto the walkway, unable to move. Hunt found Milne laying on the walkway approximately three hours after the incident. Milne was subsequently transported to Griffith Hospital and then airlifted to Prince of Wales Hospital, Sydney, where, about three weeks later, he died from his injuries.
19) Prior to the accident the Defendant had no written procedures in place for the inspection and maintenance of the rake machine.
20) Prior to the accident the Defendant did not provide to its employees any specific information, training or instruction for the inspection and maintenance of the rake machine.
21) In particular, prior to the accident, the Defendant did not have in place an isolation procedure that could be utilised when carrying out maintenance on the raking machine.
22. The Defendant did not undertake a risk assessment of the rake machine, and apart from maintenance on the machine, the Defendant did not undertake any general safety inspections. At the time of the accident, the rake machine was unguarded.
23) On 6 October 2001, Inspector Stuart Larkin conducted a factual investigation. The factual inspection report is annexed hereto as Attachment "A".
24) Attached hereto as Attachment "B" are 17 numbered photographs taken by Inspector Stuart Larkin on 6 October 2001.
25) Attached hereto as Attachment "C" are 5 numbered photographs taken by Inspector Stuart Larkin on 7 November 2001.
26) On 6 October 2001, improvement notices numbered 239871 and 239872 were issued to "Twynam Pastoral Company" which required that:
(a) All dangerous parts of the rake machine, in particular nip points created by the rake machine bars and structural components of the plant, to be securely fenced, or by other means, in order to ensure the safety of persons working around the rake machine;
(b) A lockout/tagging procedure for the rake machine to be developed and documented, or other means, to ensure the safety of persons conducting maintenance on the rake machine.
27) Subsequent to the accident, the following changes in relation to the rake machine occurred:
(a) secure fencing and guarding was installed around the rake machine;
(b) the walkway was repositioned outside the fencing/ guarding;
(c) the drippers were repositioned outside of the fencing;
(d) a sign was erected on the rake machine stating "No Entry - Authorised Personnel Only";
(e) written lockout/ tagging procedures were developed for the rake machine and employees trained in the procedure;
(f) a safety alert was issued to other properties under the control of the Defendant to inspect their rake machines and to implement similar changes.
(28) As a result of the said failures, Raymond Milne was fatally injured.