When designed, installed, and maintained properly, septic systems provide a cost-effective and environmentally-sound method to treat domestic wastewater. However, poor installation, unsuitable site conditions, and infrequent maintenance can lead to system failure and the discharge of partially-treated effluent to local waterways. As many as 1%, or 4,000 systems, fail each year in the Atlanta area. Therefore, the purpose of this paper is to evaluate what social and physical factors are significant to the location of on-site sewage management system failures in Cherokee County, Georgia. A regression analysis of the septic system failure rate, which was estimated with repair permit records from the local Board of Health, with Census demographics, soil, and septic system information found that the percent of soils in the “A” hydrologic group, unemployment rate, percent African-American population, population density, household size, percent of homes built between 1980 and 1989, percent built between 1970 and 1979, percent built between 1940 and 1949, and the average lot size of the parcels issued a repair permit were statistically-significant (p < 0.05) indicators of the failure rate at the Census block group level. The inclusion of socioeconomic, environmental, and physical characteristics suggests that the most effective response to reduce failures will incorporate actions to address these significant elements collectively. Despite restrictions on the ability of the Georgia Department of Public Health to regulate maintenance, many policy options are available to proactively identify areas with the greatest likelihood of failure and reduce the incidence of failure in those areas. Greater collaboration between stakeholders, including the county Board of Health and utility providers, improved record-keeping, and education and incentive programs provide the best opportunities to improve the management of septic systems in local jurisdictions.