Mortar pads are constructed on the headstock pedestal prior to the beam being positioned but not completed, leaving room to pour grout into each of the pedestal block out to secure the bearing imbedment studs after the girders have been erected.
9 Mr Nelson McIntosh described as the effect of the directive of BHE that "….the bearings on span 4 girders were not grouted in their final position but were left sitting on partly completed mortar pads. These mortar pads had been designed on the assumption that the bearings would be grouted into final position within 24 hours after the erection of the beams. This is necessary to ensure that the beams hold them in position. The usual practice is that this grouting is carried out no more than one day after the beams are placed onto the mortar pads."
10 Mr Nelson McIntosh had been first involved in the supervision of the work on that site until 30 June 1995 when BHE required that he cease such activity as a result of a complaint made by the Construction, Forestry, Mining & Energy Union ("CFMEU"). Thereafter and relevantly for the purpose of these proceedings the foreman duty on site was taken over by Gerard McIntosh, the son of Nelson McIntosh. Gerard McIntosh is a carpenter by trade and also holds additional trade qualifications. He has worked as a foreman on bridge building projects for eight years.
11 Mr Gerard McIntosh took over as foreman in July 1995 and his brother Brian McIntosh worked with him, as did several experienced employees.
12 In an affidavit tendered in the proceedings Mr Gerard McIntosh related how the realignment process was undertaken on 13 February 1996. The general process is described in the Agreed Statement of Facts the contents of which I have previously set out. Mr Gerard McIntosh said that about an hour after the realignment process had been carried out he noticed that the beams had again moved out of alignment, rolling inwards. He then decided to grout them into place. It was at this stage that another employee warned him that the first beams had begun to collapse and he was forced to run off the deck and onto an adjacent span to avoid being struck. He said that the incident commenced because the first beam rolled inwards before falling to the ground. Its collapse triggered the collapse of the other beams because they had been braced to each other.
13 In his affidavit Mr Gerard McIntosh referred to the fact that personnel from Snowy Mountains Engineering Corporation Ltd ("SMEC") had discovered at least by 9 February 1996 that the gap between the erected girders had decreased to the point where the concrete flanges were rubbing together and that this may have suggested some defect in the bearings. On 12 February 1996 a "corrective action request" form was issued by SMEC which named the contractor as Baulderstone Hornibrook Engineering Pty Ltd. That form stated that corrective action was required to rectify a "condition adverse to quality" namely "Gap between erected girders has decreased to the point where minor spalling is occurring. This may also have implications for the bearings." The concerns of SMEC were not raised with the defendant prior to the realignment process on 13 February. Mr McIntosh said that if he had been aware that the bearings were damaged this would have influenced "greatly the decision about the process that would be implemented to realign the beams. Without doubt the fact that the bearings were unstable would have influenced the procedure adopted by us in correcting their alignment. We may have chosen to take no action at all, or at least consult with BHE engineers before attempting any realignment."
14 Mr Nelson McIntosh inspected the site on 16 February 1996. He formed the view that "the collapse had occurred because the upstream mortar pads under the bearings had collapsed due to a change in the weather and the length of time which the mortar pads had been in place and not grouted. This expansion, due to the heat and prevailing wind conditions, caused the most outer beam to move upstream which caused it to come off its position and to slip off the cross head. The beam then rolled inwards as a result of the crumbling of the mortar pad where it dropped and dragged the inside beams with it. Because each beam is braced to another by reinforcement metal tie bars, they were also pulled off their bearing. All of this occurred independently of Gerard's attempt to realign the beams. The position of the first beam on its side and not on the flange, in my view, confirms this theory."
15 In dealing with theories put forward by SMEC and BHE as to how the incident occurred Mr Nelson McIntosh said:
"I disagree with the theory of the collapse put forward by SMEC and BHE. They each blame inadequate or insufficient external bracing for the attempt to realign beams of this size and length. However, the collapse occurred shortly after the realignment had been completed, and in circumstances in which it is difficult to contemplate the extent of bracing that would have been necessary to support all beams on the span. The instability of the mortar pads, which was not known to Nelmac, would have undermined any system of bracing put in place prior to the realignment."
16 It is clear on the evidence that the defendant had not previously encountered a situation where it had been compelled to defer the precise alignment of the girders after they had been put into place for such a considerable time. Accordingly, when work had previously been carried out by it, there was no question about the integrity of the bearing or the pedestal, especially if they had been mortared into place. As Mr Nelson McIntosh said, they had no established procedures for dealing with such a situation, and do not appear to have received any guidance either from BHE or SMEC.
17 A report submitted by SMEC and prepared by a Mr Bill So, an engineer queried the explanation given on behalf of the defendant. Mr So questioned whether the girders could have in fact rolled over after they had been secured in the manner described by defendant personnel. He was of the opinion that the method in which the defendant's personnel had endeavoured to stabilise the girders during the realignment process was incorrect and in fact had exerted pressure on a girder other than the one which was being realigned by reason of the tension created by the use of the chain. This created a domino effect causing all of the girders to move. He also said that "it was possible that the strong wind played a part at the critical time in this process."
18 A report prepared by Mr C Peacock, the resident SMEC engineer on site also queried the work system used by the defendant's personnel in the realignment process. He said that the use of the chain subjected the bearings to "lateral movement which they are not designed to withstand." Accordingly they had been inadequately restrained. He thought that Mr Gerard McIntosh was not sufficiently experienced for this process but commented also that "Baulderstone do not appear to have the expertise to determine whether the work system underway at the time was safe or not, having no-one on site at the time experienced in the erection of precast concrete girders."
19 A report compiled by Mr Gary Girvan, Technical Services Manager, Civil Infrastructure of Baulderstone Hornibrook Engineering said that "it appears obvious that the overriding factor contributing to the over-turning of the girders is the absence of grout in the pedestal block outs which would have locked the girders into position and ensured that bearings were completely supported in completing the mortar pads as part of the grouting process. The girders were left in this state for about four weeks, during which time girder movements due to temperature and hog as well as vibration during construction and access, would have undoubtedly resulted in some movement of the girder in relation to the bottom bearing plate and possibly the bottom bearing plate in relation to the pedestal." Mr Girvan also noted some defects in the mortar pads and the fact that some "block outs" in the headstock pedestals were out of position by up to 70mm. "This means that if the girder weight was transferred to the west, it was all being resisted by about 90mm of mortar strip on the northern edge and the reinforcement tie to girder 4 at the flange. I believe that this was a major contributor to the incident."
20 Mr Girvan also criticised the sequence and method of adjusting the girder cambers during the realignment process undertaken by the defendant. This sequence and method would have "progressively created an inbuilt turning movement in every girder - wanting to return to their previous natural state." In addition, the girders were not restrained at the bearing level following adjustment which allowed sliding to occur and movement of the girders was exacerbated by the low friction bearings which were used.
21 A report prepared by Mr Colyn Jones, Manager, Bridge Designer Projects and Mr Thomas Stewart, a concrete inspector of the Roads and Traffic Authority noted that the mortar pads on the relevant piers consisted of non-shrink grout. It probably had a high strength but would have been relatively brittle. The bearers had been attached to the girders before the girders were put in place. There was conflict as to whether the girders were correctly aligned at the time that they were originally positioned. In any event they appear to have moved further out of position after erection because they had not been sufficiently braced. They also noted that the centre of gravity of each girder was not directly over the centre of the bearing and if the girders were not braced at erection any stability may be reduced. "If the bearing top plate moves laterally relative to the bearing the girder can become unstable ie. will fall over sideways. Lateral movements in the order of 50mm would cause instability."
22 Accordingly, the girders as erected "were not very stable" because of these factors.
23 Messrs Jones and Stewart also criticised the realignment process undertaken by the defendant. They said "moving the top of the girders would tend to have distorted or broken the bearing transit clamps and then caused the bearing sliding surfaces to move and for the pot to rotate. Also, the bearing mortar pad would tend to crumble due to their relative small area and shape." That is, the movement of the girders at the top caused damage to the bearings and the bearing transit clamps which would have then allowed movement and could have caused either the mortar pad or a bearing to have crumbled particularly under one of the girders. This would have brought about a collapse of all of them.
24 Messrs Jones and Stewart criticised the lack of reference to erection procedures on the drawings and suggested a form of revised procedure. This appears to have been the responsibility of the bridge designer, named as Maunsell Pty Ltd.