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Was it smoking or any other type of tail pipe emissions?
Is this a van body ambulance (single rear wheel) or a cab chassis ambulance (usually a dually)? That'll give an idea on how big it is....and heavy.
Also, look on your door at the vin, weights sticker. What's the axle code? It'll mention what the ratio is. I'm guessing it's prob a 4:10....
As stated, check/change the filters. Jersey is "sea level" (close to it) and fairly flat. Colorado isn't exactly at sea level either. Maybe the injection pump was "optimized" for sea level...
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1999 E-350 Cub Wagon, 7.3L Power Stroke, E4OD, 3.55 
1990 E-350 Club Wagon, 7.3L IDI, E4OD, 3.54LS x2
1983 F-150 2x4, 4.9L, C-6 w/GV-OD, 3.55 Farm pickup
1981 C-8000, 3208 CAT, RT-6510, Rockwell SSHD Tandems (Swap)
1977 K100C, NTC-350, RT-1110, Tandem
1977 Transtar II, NTC-290, RT-9509 Single
1977 Transtar II, Formula 290, RT0-9513, Tandem
1974 C-750, 391CID, Clark 5 speed, Eaton 2 speed
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