Tates Creek (Madison County, Kentucky) is characterized by an oversupply of nutrients and fecal microbe contamination. Its watershed is dominated by pastureland and immature woodlands with scattered settlements served by septic systems, whereas ~5% of the watershed drains urban areas of Richmond, Kentucky. Creek waters are eutrophic and commonly display levels of Escherichia coli deemed unfit for human contact by United States Environmental Protection Agency standards. Both point and non-point sources existed for stream contaminants. A secondary sewage treatment plant (STP) discharged effluent into the creek until mid-2011 and was a point source for nitrate and phosphate. Pastureland likely contributes dissolved nutrients as well. High ammonium levels occurred sporadically, only sometimes related to plant discharge. After plant shutdown, nutrient levels downstream of the former STP decreased markedly for nitrate and phosphate, but phosphate then became the principal nutrient contaminant, suggesting that nitrogen may be the limiting nutrient within the stream ecosystem. Fecal microbes enter the stream from the sewer system serving the town of Richmond, from cattle farming, and from large developments served by septic systems. We cannot demonstrate any fecal contamination from single-residence septic systems.