Abstract: At approximately 3:00 a.m. on February 17, 2007, Employee #1 and a rail crew operator were working to increase the flow rate of aggregate from a hopper onto a conveyer belt. Employee #1 was trying to turn a four prong wheel handle used to lift the slide gate on the hopper. Employee #1 was unable to move the slide gate by hand, so he placed a 42-in. cheater pipe over one of the four prongs on the wheel handle to gain leverage. As Employee #1 was pulling downward on the cheater pipe, the pipe slipped off the wheel prong and Employee #1 stumbled backward off the working platform and fell 42 in. to the ground. Employee #1 fell into a 24-in. gap between the platform and the wall. Employee #1 landed with his head down and the weight of his body resting upon his head and neck. Employee #1 was killed. The autopsy report identified the cause of death as positional asphyxia.