In terms of deciding what happened there are still two possibilities to be examined: contaminated water ran across the surface into the Mangateretere Pond during a high rainfall event then either entered the bore (i) via the aquifer or (ii) via a hole in the well casing.
In the second scenario there is no pathway through the impervious layer but contaminated groundwater flowed around the well and entered the water supply via a hole in the well casing.
A lot of smoke has been wafted around by Hawkes Bay Regional Council, Hastings District Council as well as a lot of private submitters to the Inquiry concerning the cause of the gastro outbreak and, by extension, who is to blame. This report clears the air considerably but, unfortunately, will probably not result in any clear accountability.
Reports suggest that both HBRC and HDC knew about this hydraulic connection as early as 2008. We wait to find out who knew what and when but until then it is likely that the division of responsibilities between HBRC, HDC and the Hawkes Bay District Health Board mean that we simply won't be able to finger one organisation let alone an individual.