In the study described in this article, the authors’ objective was to use community-owned and -managed research (COMR) to assess the safety and adequacy of water and sewer services in three low-income African-American communities in Mebane, North Carolina. Community monitor (CM) training workshops, household surveys, and drinking water and surface water tests of fecal pollution were completed at private (target) and regulated public (referent) service households. CMs collected survey data showing a mixture of failing private wells and septic systems and regulated public drinking water and sewer infrastructure. Drinking water and surface water fecal pollution levels exceeded limits protecting health at target and referent households. COMR methods built community capacity to investigate private and regulated public drinking water and sewer service failures. Drinking and surface water fecal contamination levels suggest a need for provision of improved water and sewer services to protect health in these underserved and marginalized communities.