One nail is the easy version of this job. Find it, ream it, plug and patch it from the inside to BS AU 159, balance the wheel, done. The awkward version is the tyre with two things in it, and that turns up far more often than people expect on cars which spend their whole week on the same few roads.
Two changes the arithmetic. The standard lets a tyre carry more than one repair, but not two injuries close enough that the patches would crowd each other, and not two that have already been joined by a split in the casing between them. So a second nail is not simply a second small job. It can be the thing that condemns a tyre which would otherwise have been saved, and that is a verdict better reached with the casing in hand than over the phone.
Which is why the whole tread gets checked bead to bead rather than just the bit you pointed at. A screw you can see is a screw. The one you cannot see is usually the reason somebody else's repair got blamed for failing.
DVSA-compliant is not marketing language, it is a description of the method. We do it that way every time, at the car anywhere in SM1, and where the damage falls outside what the standard allows we say so and fit a replacement instead. Ring at 3am from Benhilton and someone answers; Belmont at noon is no different. A 4am Cheam call and a noon Rosehill call reach the same fitter.

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Cars around here do short, repetitive journeys: the run up to Sutton High Street, over to Cheam and back, the same turning into the same street every evening. Whatever is lying in that road gets driven over again and again by the same four tyres, which is exactly how one tyre ends up with two things in it.
The driver had found a roofing nail and marked it with tape. With the wheel off and the tyre under water we found a second, finer one about a hand's width away. Both sat centrally and far enough apart to take separate patches.
Somebody else had patched this tyre a fortnight earlier and it was down again. Their work was perfectly sound. A second screw sat two tread blocks over from the first, flush with the surface and impossible to spot with the wheel on the car.
Two punctures within a couple of centimetres of one another, with the casing already torn between them. That is one injury pretending to be two, and there is no honest way to patch it. The tyre was replaced and the owner shown why.
Most often because there was more than one. A tyre with a second puncture goes down slowly enough that people blame the patch, the valve or the wheel instead. The way to settle it is to take the tyre off and put the whole casing under water.
More than one, provided each sits in the repairable band of the tread, each has sound casing around it, and they are far enough apart that the patches do not overlap. What ends it is proximity, not the count.
By taking the tyre off the rim, inflating it and putting it under water bead to bead. A fine screw with a flush head can seal itself well enough to show nothing at all with the wheel on the car.
A repair made to the standard leaves the original rating intact and is meant to last the life of the tread. What changes things is a repair done badly, or one put somewhere the standard does not allow.
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