Two nails in the same tyre is not twice the problem, it is a different problem. A single puncture in the middle of the tread is straightforward enough: the tyre comes off the rim, the injury is cleaned out, and a patch goes over it on the inside, bonded to the liner. Add a second injury and there are two further questions to answer. Are both of them inside the area a repair is permitted in, and are they far enough apart that the two patches do not touch or leave a narrow strip of casing working away between them?
If the answers are yes and yes, both get repaired and the tyre goes back onto the wheel. If the two sit close together, the repair is refused, because the material between them is the part that would have to carry the load and it has now been injured on both sides. There is also a sensible ceiling on how much of one tyre can be patched before keeping it stops making sense. None of this can be judged from outside, where two screw heads a hand's width apart look no different from two an inch apart until the tyre is off the wheel and the inside has been measured.
A repair costs a fraction of a new tyre, which is exactly why it is worth having someone look properly instead of guessing. We check that with the tyre off the rim, on the spot, in Shepherd's Bush, and you get an honest answer including the one you were hoping not to hear. Which street in Brackenbury, which way the car sits in Goldhawk Road, and we are set. Boxed in on an Uxbridge Road terrace or wide open in Askew Road, say which on the phone.

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Uxbridge Road and the streets around Shepherd's Bush Green take constant delivery and loading traffic, and that is the profile of road which puts fasteners and offcuts down where cars run over them. Picking up several at once is far more common here than a single tidy nail, which is why the repair question so often comes down to spacing rather than to whether any one hole qualifies. If a tyre has gone down quickly rather than over days, assume there is more than one thing in it until somebody has had it off the wheel.
A car parked off Askew Road had collected three in a single afternoon, which nearly always means it has driven through one particular mess rather than been unlucky three separate times. Two were repairable and the third decided the outcome.
A tyre came off for one puncture and turned out to have another in it that had sealed itself around the object and never lost enough air to be noticed. The spacing between the two made the decision straightforward.
When one tyre has collected several, the rest of the car has been over the same ground. Running a hand around the other three takes a minute and fairly often turns something up before it becomes a call at midnight.
Yes, provided each injury sits inside the permitted area, each is small enough to qualify, and the patches sit clear of one another. What rules it out is two injuries close together, because the casing between them ends up doing the work with damage on either side of it.
Close enough that the patches would overlap, or would leave only a narrow band of undamaged casing between them. It is measured on the inside of the tyre with the tyre off the wheel, which is the only place the answer exists. From the tread the two cases look much the same.
Almost always by driving across one patch of debris rather than by bad luck repeating itself. That is why we look over the other tyres when one comes in with a collection in it, since whatever was lying on the road passed under all four wheels.
A properly made repair does not shorten tread life and does not need declaring to anybody. What accumulates is the amount of casing that has been injured, which is why there is a limit on how many one tyre should carry rather than a rule against the first one.
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